HEATHER KETTERLING (NPI# 1124684915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124684915 |
| Entity Type | Individual |
| Full Name | HEATHER KETTERLING |
| Other Name | HEATHER FULLER |
| Credential | LMT |
| Practice Address |
3242 20th St S Fargo ND 58104-5917 |
| Practice Telephone | 7018932639 |
| Practice Fax Number | 7018932638 |
| Mailing Telephone | 7018932639 |
| Mailing Fax Number | 7018932638 |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 961 | ND | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659424323 | Heather Marie Ketterling | Speech-Language Pathologist | 8100 Penn Ave S Ste 169, Minneapolis, MN 55431-1325 | 2007-01-18 |
| Street Address |
3242 20TH ST S |
| City | FARGO |
| State | ND |
| Zip Code | 58104-5917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235119892 | Amanda Helgoe | Physical Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2006-01-19 |
| 1639703861 | Natalie Sticka | Massage Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2020-02-26 |
| 1578052239 | Nicole L Jefferson | Physical Therapist | 3242 20th St S, Fargo, ND 58104 | 2018-05-08 |
| 1255857629 | Savannah Marie Mcdaniel | Massage Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2017-08-17 |
| 1396294435 | Samantha Lynn Stegman | Physical Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2016-09-30 |
| 1689085177 | Body Works Physical Therapy, Ltd. | Massage Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2014-05-19 |
| 1871915033 | Andrew Zimmerman | Physical Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2014-01-07 |
| 1245525682 | Claire F Grunewald | Physical Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2011-06-14 |
| 1487960522 | Body Works Physical Therapy, Ltd. | Clinic/Center | 3242 20th St S, Fargo, ND 58104-5917 | 2010-08-26 |
| 1750470746 | Sara Jean Metzger | Physical Therapist | 3242 20th St S, Fargo, ND 58104 | 2006-10-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255820 | Eric B Glass | Massage Therapist | 5257 27th St S, Fargo, ND 58104-7780 | 2020-01-31 |
| 1508393505 | Annie Rose Larsen | Massage Therapist | 3222 28th St S Ste A, Fargo, ND 58104-5183 | 2017-05-22 |
| 1225416886 | Matt Simmons | Massage Therapist | 4955 17th Ave S Ste 116, Fargo, ND 58103-3372 | 2015-05-14 |
| 1497143317 | Stephanie Wilson | Massage Therapist | 1790 32 Nd Ave South Suite 1a, Fargo, ND 58104 | 2014-12-30 |
| 1689096125 | Katie E Stock | Massage Therapist | 2553 Kirsten Ln S Ste 207, Fargo, ND 58104-4901 | 2014-01-17 |
| 1205175544 | Ann Hazel Terry | Massage Therapist | 2600 52nd Ave S Ste 103, C/o Urban Edge, Fargo, ND 58104-7173 | 2013-02-06 |
| 1104129527 | Lisa Marie Wourms | Massage Therapist | 1121 Westrac Dr S Ste 102, Fargo, ND 58103-2385 | 2010-12-07 |
| 1245544147 | Jennifer Lynn Nett | Massage Therapist | 3120 15th St S, Fargo, ND 58103-5939 | 2010-08-03 |
| 1639703861 | Natalie Sticka | Massage Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2020-02-26 |
| 1508355041 | Carly Shae Bjornstad | Massage Therapist | 3222 28th St S, Fargo, ND 58104-5183 | 2018-05-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.